Addressing the HIV Epidemic Among Gay Men of all Races and Ethnicities

By Meico Whitlock July 30, 2013

In May, during our 22ndAnnual Meeting of state health department HIV and hepatitis program leaders in Washington, D.C., we hosted a discussion about the opportunities and challenges of addressing the prevention and care needs of gay men in the era of the National HIV/AIDS Strategy (NHAS), High Impact Prevention (HIP) and the Affordable Care Act (ACA). The following is an interview with Isaiah Webster, Senior Manager, Health Equity and Prevention at NASTAD, and James Markiewicz, Director, Maine HIV, STD, and Viral Hepatitis Program, who shared their reflections on the session.

NASTAD: Thank you for taking a moment to speak with us, Isaiah. Could you share an overview of the focal points of the discussion?

Isaiah Webster (IW): I think one of the key points for me is that we need to think about what gay men want, particularly young gay men, and not assume that what we’ve always done is the right way. I think that was a consistent theme in some of the comments that people made in the session. From the NASTAD perspective, we need to ensure we’re thinking strategically and outside the box about what can be done. I thought James shared a good model from Maine, in reference to a YMSM retreat that covers a variety of topics such as HIV prevention, substance use, and relationship violence. At the end of the retreat, HIV testing and referrals for testing are provided. Like this, I think people just need to think more unconventionally about how to reach populations whose top concern is not HIV/AIDS.

NASTAD: What can health department leaders do different to reach and engage gay men when they go back to their states?

IW: Engage individuals from the populations you want to reach. I think that was highlighted. Go directly to them and find out what they want, and given what they want, see what we can do to meet those needs, and in addition to that, see how we can leverage the needs of HIV within the context human rights, civil rights, and all of the other things impacting gay men’s lives. We have examples like the Gay Men’s Health Crisis’ “I love my Boo” campaign in New York. Why have campaigns like these been effective? Is it because it’s an HIV campaign, or is it because it empowers gay men around being gay men of color? Ultimately, we have to adopt a more holistic approach to addressing the needs of gay men of color.

NASTAD: Thank you, Isaiah. James, from your perspective as someone who works in a health department at the state level, what are your key takeaways from today’s session on gay men?

James Markiewicz (JM): We’re focusing on some of these larger policy issues and we’re missing this opportunity to have a serious dialogue about gay men and gay men of color, in particular, which clearly from all the data that we have, are still the most impacted population of this epidemic. I feel like they’re not participating in those conversations, and for me, that’s one of the take homes from today.

NASTAD: What do you see yourself doing differently when you get back to your state, based on what you learned today?

JM: Well, one of the things that we’re doing now, for instance, is working with  a group called the “HIV warriors.” It’s a small group of HIV-positive people who are outside of our Ryan White Advisory Committee and that are outside of any of the others things that we are doing. Essentially, we’re providing them an opportunity to get together and have a dialogue themselves about what’s working and what’s not working, outside of the framework of all this other planning we have to do. We’re looking to them, and particularly to HIV-positive people, to help get the information out and to create some more advocates in the community, and in turn, to bring folks in. So far through this process, we’ve started with three folks, and they recruiting additional people. I’m thinking a similar model with young men who have sex with men (MSM) and other MSM framed like this is something we would want to do—start small, assemble some folks who are really invested and interested in the topic, and work from there, instead of trying to look for big, broad ways to engage the community. I think hearing from the session today, it’s a struggle for folks all around—engaging people in this conversation has been difficult.

NASTAD: Thank you both for your time.

What other ways are there to directly involve gay men/MSM in assessing their treatment and care options? Share your ideas below.